Alternative Names

Causes

Coronary artery disease
due to atherosclerosis
is the most common cause of unstable angina. Atherosclerosis is the buildup of fatty material, called plaque, along the walls of the arteries. This causes arteries to become narrowed and less flexible. The narrowing interrupts blood flow to the heart, causing chest pain.

People with unstable angina are at higher risk of having a heart attack.

Coronary angiography
. This test involves taking pictures of the heart arteries using x-rays and dye. It is the most direct test to diagnose heart artery narrowing and find clots

Treatment

Your doctor may want you to check into the hospital to get some rest, have more tests, and prevent complications.

Blood thinners (antiplatelet drugs) are used to treat and prevent unstable angina. You will receive these drugs as soon as possible if you can take them safely. Medicines include aspirin and the prescription drug clopidogrel or something similar. These medicines may be able to reduce the chance of a heart attack or the severity of a heart attack that occurs.

During an unstable angina event:

You may get heparin (or another blood thinner) and nitroglycerin (under the tongue or through an IV)

Other treatments may include medicines to control blood pressure, anxiety, abnormal heart rhythms
, and cholesterol (such as a statin drug)

A procedure called angioplasty
and stenting can often be done to open a blocked or narrowed artery

Angioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to the heart.

A coronary artery stent
is a small, metal mesh tube that opens up (expands) inside a coronary artery. A stent is often placed after angioplasty. It helps prevent the artery from closing up again. A drug-eluting stent has medicine in it that helps prevent the artery from closing.

Prevention

Some studies have shown that making a few lifestyle changes can prevent blockages from getting worse and may actually improve them. Lifestyle changes can also help prevent some angina attacks. Your doctor may tell you to:

Lose weight if you are overweight.

Stop smoking.

Exercise regularly.

Drink alcohol in moderation only.

Eat a healthy diet that is high in vegetables, fruits, whole grains, fish, and lean meats.

Your doctor will also recommend that you keep other health conditions such as high blood pressure, diabetes, and high cholesterol levels under control.

If you have one or more risk factors for heart disease, talk to your doctor about taking aspirin or other medicines to help prevent a heart attack. Aspirin therapy (75 - 325 mg a day) or drugs such as clopidogrel, ticagrelor or prasugrel may help prevent heart attacks in some people. Aspirin therapy is recommended if the benefit is likely to outweigh the risk of side effects.

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

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